Having a hip labral tear DOES NOT necessarily mean the pain is from the labrum. What??? I know, it makes you scratch your head. If something is torn, how could it possibly NOT be causing pain. The research I am referring to evaluated MRIs of hockey players. The conclusion was:
“Hip/pelvis pathology is commonly uncovered on MRI of asymptomatic hockey players; however, this pathology does not produce symptoms or result in missed games within 4 years in most players.”:
(Gallo, Robert A. et al., 2014, p.1222)
AND DID YOU KNOW…. it takes an average of 2 YEARS to get a proper hip diagnosis???!!
Why is diagnosing hip pain so difficult?
Imaging, although reliable, is only one of many medical tools. The same image can lead to multiple diagnoses. The most accurate way to see the hip labrum without cutting into the skin, is by undergoing a MRI with contrast (injected dye). Even if we can confirm that the labrum is torn, as stated earlier, the pain may not necessarily be coming from the labrum. Surrounding structures can also cause pain, such as the bone, or muscle. Different diagnoses lead to different treatment plans, therefore it is important to find the EXACT CAUSE.
Are you receiving treatment for hip labrum issues, but are still feeling pain? Don’t lose hope. It may just be time to reassess the original diagnosis.
If you DON’T experience pain but screen tests show you are positive for hip labrum issues it is essential to be aware of your condition. So, you are able to incorporate proper rehabilitation exercises into your training. A great way to be proactive in prevention is getting checked with a conservative practitioner that has an extensive background in sports to help create a custom rehabilitation plan.
When should you consider surgery?
Patients frequently ask me this question, and ultimately you should do what feels right for you. If I was the patient, I would consider surgery when conservative care fails. I would at least try 4 to 6 visits to see some form of change, and if there is absolutely no changes in a couple months, ask for the diagnosis to be reassessed.
Conservative care is hard work. Following rehabilitation protocol is crucial to objectively see your progress. During treatment, try, try, try to rest as much as possible. Think of it as investing time NOW for a longer active future.
Let us know what you think below, and feel free to suggest any topics. If you have personal questions about your specific condition, you may email us directly by clicking here.
References:
Gallo R.A., Silvis M.L., Smetana B., Stuck D., Lynch S.A., Mosher T.J., Black K.P. (2014). Asymptomatic hip/groin pathology identified on magnetic resonance imaging of professional hockey players: Outcomes and playing status at 4 years’ follow-up. Arthroscopy – Journal of Arthroscopic and Related Surgery, 30 (10) , pp. 1222-1228. doi: http://dx.doi.org/10.1016/j.arthro.2014.04.100
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